Figure out which people or events press your buttons and learn to avoid or adapt as needed.

Try asserting yourself in a calm manner when something bothers you instead of exploding or holding it in.

Control your inner reactions to anger: Breathe deeply from your belly, not your chest. Think of a relaxing experience, either from memory or imagination.

They don’t call it a hearty laugh for nothing

They don’t call it a hearty laugh for nothing

Turns out a hearty sense of humor may do the heart a world of good. University of Maryland researchers studied 150 patients who had experienced either a heart attack or bypass surgery and used two questionnaires to compare their sense of humor to that of 150 healthy people.

The first questionnaire asked them to rate the humor they found in 20 hypothetical situations; the second measured their anger and hostility levels. What researchers found: Patients with heart disease were about half as likely as the healthy group to respond with laughter. What’s more, the lower their humor score, the higher their levels of anger and hostility—two factors that may increase blood pressure and possibly cardiac risk.

Can laughter protect the heart? Researchers don’t know for sure, but they do point out that laughter releases opioid-like compounds in the brain and lowers pulse and blood pressure. More studies are under way, but in the meantime, researchers are wondering whether laugh therapy should be incorporated into cardiac rehabilitation programs.

How you think. How you feel. Your outlook on life. Could these possibly affect your cardiovascular fitness? The scientific community is beginning to think they can. While conclusions and guidelines are still being debated, a link between mental health and heart health seems to be emerging.

The depression factor

Mounting evidence suggests that where there is depression, there may be heart disease, too. A recent study reported an increased risk for coronary heart disease in people with depression, an illness that affects between 17 million and 20 million Americans a year.

In the first study of its kind to examine the effects of depression on heart patients, researchers took pains to analyze data separately for women and men. All told, the authors found that depressed women were at a 73 percent greater risk for coronary heart disease events than women who were not depressed. However, the depressed women were not at an increased risk of dying from those events. Men, on the other hand, had a 71 percent greater risk of a coronary heart disease incident and were also 2.34 times more at risk of dying from them than men who were not depressed.

Other studies point to a connection between heart disease and depression. In one, patients who already were diagnosed with both heart disease and clinical depression had more difficulty working and socializing and reported more heart disease symptoms than those cardiac patients who did not show signs of depression. The study concluded that depression—even a minor episode—should not go untreated in heart patients.

The anger effect

Recent research findings suggest that anger and hostility may also be hard on the heart. Nearly 13,000 people were studied for six years, none of whom had experienced a heart attack when the study began. By the end of the study, 256 participants had had heart attacks. Those who scored highest on an anger questionnaire administered at the study’s start were almost three times more likely to have suffered a heart attack or sudden cardiac death than those who scored lowest on the anger scale. Individuals who scored moderately on the anger scale were 35 percent more likely to experience such an event. Significantly, these findings held true even after accounting for other risk factors such as smoking, diabetes, cholesterol levels and weight.

A separate study also pointed to possible connections between anger and heart disease. University of Pittsburgh researchers studied 200 healthy 47-year-old women who were asked about their anger levels, anxiety and public discomfort. About five years after the women experienced menopause, researchers used ultrasound to examine the thickness of the women’s carotid arteries, which supply blood to the brain. They found that half the women were developing plaque build-up in their arteries, an indicator of possible heart disease. The women with the buildup were more likely to be those who suppressed negative emotions such as anger.

In yet another study, German researchers followed 150 people with atherosclerosis, or narrowed arteries, for two years. The subjects underwent angiography at the beginning and at the end of the study and also filled out questionnaires assessing their levels of social support, anger and hostility. At the study’s conclusion, those who had reported high levels of anger and low levels of social support were more likely to have their atherosclerosis worsen.